Obesity is associated with worse outcomes in patients with T1 high grade urothelial carcinoma of the bladder
Kluth LA, Xylinas E, Crivelli JJ, Passoni N, Comploj E, Pycha A, Chrystal J, Sun M, Karakiewicz PI, Gontero P, Lotan Y, Chun FK, Fisch M, Scherr DS, Shariat SF. J Urol. 2013 Jan 31. pii: S0022-5347(13)00229-2. doi: 10.1016/j.juro.2013.01.089. [Epub ahead of print]

Source

Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA; Department of Urology, University Medical-Center Hamburg-Eppendorf, Hamburg, Germany.

Abstract

PURPOSE:

To our knowledge, the impact of body mass index (BMI) on oncological outcomes in non-muscle invasive bladder cancer (NMIBC) has not been evaluated. We hypothesized that higher BMI is associated with worse outcomes in patients with clinical primary T1 high-grade (HG) UCB.

MATERIAL AND METHODS:

We retrospectively analyzed data from 892 patients with primary NMIBC from seven centers. Patients were treated with transurethral resection of the bladder (TURB) with or without intravesical therapy (IVT). BMI was analyzed as continuous and categorical variable [non-obese (BMI <30kg/m2) vs obese (BMI ≥30kg/m2)]. Disease progression was defined as development of T2 or higher tumor stage.

RESULTS:

The median follow-up was 42.8 months (interquartile range (IQR): 56); 44.3% of the patients were obese and median BMI was 29.2 (IQR: 8). In univariable analyses, higher BMI and age were both associated with an increased risk of disease recurrence, progression, cancer-specific mortality, and any-cause mortality (all p=0.001). In multivariable analyses that adjusted for the effects of gender, concomitant CIS, tumor size, number of tumors, and IVT, higher BMI and age remained independent predictors of disease recurrence, progression, cancer-specific mortality, and any-cause mortality (all p<0.05). This study was limited by its design (i.e., lack of data on re-TURB and IVT protocol).

CONCLUSIONS:

Patients diagnosed with clinical T1HG UCB who are obese have worse cancer-specific outcomes compared to their non-obese counterparts. Further work is needed to improve our understanding of T1HG outcomes in the growing population of obese patients.